F as in Fat: How Obesity Threatens America¹s Future 2013

F as in Fat: How Obesity Threatens America's Future 2013

August 2013
After three decades of increases, adult obesity rates remained level in every state except for one, Arkansas, in the past year, according to <http://healthyamericans.org/health-issues/wp-content/uploads/2013/08/TFAH2013FasInFatReport29.pdf> F as in Fat: How Obesity Threatens America's Future 2013, a report from the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF). The full report is available here<http://healthyamericans.org/health-issues/wp-content/uploads/2013/08/TFAH2013FasInFatReport29.pdf>. Visit http://www.FasinFat.org/ for interactives, graphs, charts and obesity rates for the states and nation going back decades.<http://www.fasinfat.org/>
Thirteen states now have adult obesity rates above 30 percent, 41 states have rates of at least 25 percent, and every state is above 20 percent, according to the report. In 1980, no state was above 15 percent; in 1991, no state was above 20 percent; in 2000, no state was above 25 percent; in 2007, only Mississippi was above 30 percent.*
Since 2005, there has been some evidence that the rate of increase has been slowing. In 2005, every state but one experienced an increase in obesity rates; in 2008, rates increased in 37 states; in 2010, rates increased in 28 states; and in 2011, rates increased in 16 states.*
"While stable rates of adult obesity may signal prevention efforts are starting to yield some results, the rates remain extremely high," said Jeffrey Levi, PhD, executive director of TFAH. "Even if the nation holds steady at the current rates, Baby Boomers—who are aging into obesity-related illnesses—and the rapidly rising numbers of extremely obese Americans are already translating into a cost crisis for the healthcare system and Medicare."
Levi added, "In order to decrease obesity and related costs, we must ensure that policies at every level support healthy choices, and we must focus investments on prevention."
Key findings from the 2013 F as in Fat report include:
Alabama<http://healthyamericans.org/reports/obesity2013/?stateid=AL>
Alaska<http://healthyamericans.org/reports/obesity2013/?stateid=AK>
Arizona<http://healthyamericans.org/reports/obesity2013/?stateid=AZ>
Arkansas<http://healthyamericans.org/reports/obesity2013/?stateid=AR>
California<http://healthyamericans.org/reports/obesity2013/?stateid=CA>
Colorado<http://healthyamericans.org/reports/obesity2013/?stateid=CO>
Connecticut<http://healthyamericans.org/reports/obesity2013/?stateid=CT>
Delaware<http://healthyamericans.org/reports/obesity2013/?stateid=DE>
District of Columbia<http://healthyamericans.org/reports/obesity2013/?stateid=DC>
Florida<http://healthyamericans.org/reports/obesity2013/?stateid=FL>
Georgia<http://healthyamericans.org/reports/obesity2013/?stateid=GA>
Hawaii<http://healthyamericans.org/reports/obesity2013/?stateid=HI>
Idaho<http://healthyamericans.org/reports/obesity2013/?stateid=ID>
Illinois<http://healthyamericans.org/reports/obesity2013/?stateid=IL>
Indiana<http://healthyamericans.org/reports/obesity2013/?stateid=IN>
Iowa<http://healthyamericans.org/reports/obesity2013/?stateid=IA>
Kansas<http://healthyamericans.org/reports/obesity2013/?stateid=KS> Kentucky<http://healthyamericans.org/reports/obesity2013/?stateid=KY>
Louisiana<http://healthyamericans.org/reports/obesity2013/?stateid=LA>
Maine<http://healthyamericans.org/reports/obesity2013/?stateid=ME>
Maryland<http://healthyamericans.org/reports/obesity2013/?stateid=MD>
Massachusetts<http://healthyamericans.org/reports/obesity2013/?stateid=MA>
Michigan<http://healthyamericans.org/reports/obesity2013/?stateid=MI>
Minnesota<http://healthyamericans.org/reports/obesity2013/?stateid=MN>
Mississippi<http://healthyamericans.org/reports/obesity2013/?stateid=MS>
Missouri<http://healthyamericans.org/reports/obesity2013/?stateid=MO>
Montana<http://healthyamericans.org/reports/obesity2013/?stateid=MT>
Nebraska<http://healthyamericans.org/reports/obesity2013/?stateid=NE>
Nevada<http://healthyamericans.org/reports/obesity2013/?stateid=NV>
New Hampshire<http://healthyamericans.org/reports/obesity2013/?stateid=NH>
New Jersey<http://healthyamericans.org/reports/obesity2013/?stateid=NJ>
New Mexico<http://healthyamericans.org/reports/obesity2013/?stateid=NM>
New York<http://healthyamericans.org/reports/obesity2013/?stateid=NY>
North Carolina<http://healthyamericans.org/reports/obesity2013/?stateid=NC> North Dakota<http://healthyamericans.org/reports/obesity2013/?stateid=ND>
Ohio<http://healthyamericans.org/reports/obesity2013/?stateid=OH>
Oklahoma<http://healthyamericans.org/reports/obesity2013/?stateid=OK>
Oregon<http://healthyamericans.org/reports/obesity2013/?stateid=OR>
Pennsylvania<http://healthyamericans.org/reports/obesity2013/?stateid=PA>
Rhode Island<http://healthyamericans.org/reports/obesity2013/?stateid=RI>
South Carolina<http://healthyamericans.org/reports/obesity2013/?stateid=SC>
South Dakota<http://healthyamericans.org/reports/obesity2013/?stateid=SD>
Tennessee<http://healthyamericans.org/reports/obesity2013/?stateid=TN>
Texas<http://healthyamericans.org/reports/obesity2013/?stateid=TX>
Utah<http://healthyamericans.org/reports/obesity2013/?stateid=UT>
Vermont<http://healthyamericans.org/reports/obesity2013/?stateid=VT>
Virginia<http://healthyamericans.org/reports/obesity2013/?stateid=VA>
Washington<http://healthyamericans.org/reports/obesity2013/?stateid=WA>
West Virginia<http://healthyamericans.org/reports/obesity2013/?stateid=WV>
Wisconsin<http://healthyamericans.org/reports/obesity2013/?stateid=WI>
Wyoming<http://healthyamericans.org/reports/obesity2013/?stateid=WY>

* Rates vary by region. Of the states with the 20 highest adult obesity rates, only Pennsylvania is not in the South or Midwest. For the first time in eight years, Mississippi no longer has the highest rate—Louisiana at 34.7 percent is the highest, followed closely by Mississippi at 34.6 percent. Colorado had the lowest rate at 20.5 percent.
* Rates vary by age. Obesity rates for Baby Boomers (45-to 64-year-olds)** have reached 40 percent in two states (Alabama and Louisiana) and are 30 percent or higher in 41 states. By comparison, obesity rates for seniors (65+ years old) exceed 30 percent in only one state (Louisiana). Obesity rates for young adults (18-to 25-year-olds) are below 28 percent in every state.
* Rates by gender are now consistent. Ten years ago, there was nearly a 6 percentage point difference between rates for men and women (men: 27.5 percent, women: 33.4 percent), and now rates are nearly the same (men: 35.8 percent, women 35.5 percent). Men's obesity rates have been climbing faster than women's for this last decade.
* Rates of "extreme" obesity have grown dramatically. Rates of adult Americans with a body mass index (BMI) of 40 or higher have grown in the past 30 years from 1.4 percent to 6.3 percent—a 350 percent increase. Among children and teens (2-to 19-year-olds), more than 5.1 percent of males and 4.7 percent of females are now severely obese.
* Rates vary by education. More than 35 percent of adults ages 26 and older who did not graduate high school are obese, compared with 21.3 percent of those who graduated from college or technical college.
* Rates vary by income. More than 31 percent of adults ages 18 and older who earn less than $25,000 per year were obese, compared with 25.4 percent of those who earn at least $50,000 per year.
In addition to the latest data showing a stable rate for adult obesity, a new report<http://www.cdc.gov/VitalSigns/ChildhoodObesity/> released by the Centers for Disease Control and Prevention (CDC) earlier this month shows 18 states and one U.S. territory experienced a decline in obesity rates among preschool children from low-income families. The report provides state-specific trends in obesity rates among children ages 2 to 4 who are enrolled in federal health and nutrition programs, such as the Special Nutrition Program for Women, Infants, and Children (WIC).

"After decades of unrelenting bad news, we're finally seeing signs of progress. In addition to today's news about the steady rates for adults, we've seen childhood obesity rates declining in cities and states that were among the first to adopt a comprehensive approach to obesity prevention," said Risa Lavizzo-Mourey, MD, RWJF president and CEO. "But no one should believe the nation's work is done. We've learned a lot in the last decade about how to prevent obesity. Now it's time to take that knowledge to scale."
F as in Fat features a series examining high-impact policies to prevent and reduce obesity in the United States. The series highlights significant policy accomplishments over the past decade, including: historic changes to nutrition standards for school foods; improved health screenings for children; changes to improve nutrition and health counseling in the WIC program; increased understanding about how the built environment affects our ability to eat healthy foods and be physically active; the growth of a "complete streets" movement; the launch of a Prevention and Public Health Fund and National Prevention Strategy; and a growth in community-based programs for obesity and related illnesses.
The report includes a growing set of strategies that have improved health– but stresses that they are not yet implemented or funded at a level to reduce obesity trends significantly. Some key recommendations from the report regarding strategies that should be taken to scale include:

* All food in schools must be healthy;
* Kids and adults should have access to more opportunities to be physically active on a regular basis;
* Restaurants should post calorie information on menus;
* Food and beverage companies should market only their healthiest products to children;
* The country should invest more in preventing disease to save money on treating it;
* America's transportation plans should encourage walking and biking; and
* Everyone should be able to purchase healthy, affordable foods close to home.
The full report with state rankings in all categories and new interactive maps are available at fasinfat.org<http://fasinfat.org/>. TFAH and RWJF collaborated on the report, which was supported by a grant from RWJF.
2012 STATE-BY-STATE ADULT OBESITY RATES
According to recently released CDC data, part of the 2012 Behavioral Risk Factor Surveillance Survey, adult obesity rates by state from highest to lowest were:
Note: 1 = Highest rate of adult obesity, 51 = lowest rate of adult obesity.
* In 2011, the CDC modernized the methodology for BRFSS, setting a new baseline for comparisons. The updated approach, incorporating cell phones and using an iterative proportional fitting data weighting method, means rates are even more reflective of each states' population, but that the rates were determined in a different way than before 2011, which limits the ability to make direct change comparisons.
1. Louisiana (34.7%); 2. Mississippi (34.6%) 3. Arkansas (34.5%); 4. West Virginia (33.8%); 5. Alabama (33%); 6. Oklahoma (32.2%); 7. South Carolina (31.6%); 8. Indiana (31.4%); 9. Kentucky (31.3%); 10. (tie) Michigan and Tennessee (31.1%); 12. Iowa (30.4%); 13. Ohio (30.1%); 14. Kansas (29.9%); 15. (tie) North Dakota and Wisconsin (29.7%); 17. (tie) Missouri and North Carolina (29.6%); 19. Texas (29.2%); 20. (tie) Georgia and Pennsylvania (29.1%); 22. Nebraska (28.6%); 23. Maine (28.4%); 24. (tie) Illinois and South Dakota (28.1%); 26. Maryland (27.6%); 27. Virginia (27.4%); 28. (tie) New Hampshire and Oregon (27.3%); 30. New Mexico (27.1%); 31. Delaware (26.9%); 32. (tie) Idaho and Washington (26.8%); 34. Nevada (26.2%); 35. Arizona (26%); 36. (tie) Alaska and Minnesota and Rhode Island (25.7%); 39. Connecticut (25.6%); 40. Florida (25.2%); 41. California (25%); 42. (tie) New Jersey and Wyoming (24.6%); 44. (tie) Montana and Utah (24.3%); 46. Vermont (23.7%); 47. (tie) Hawaii and New York (23.6%); 49. Massachusetts (22.9%); 50. District of Columbia (21.9%); 51. Colorado (20.5%).
2012 STATE-BY-STATE ADULT OBESITY RANKINGS FOR BABY BOOMERS
** (45-64 Year Olds, includes most Baby Boomers, who range from 49-67 year olds)
Note: 1 = Highest rate of adult obesity, 51 = lowest rate of adult obesity. Data for this analysis was obtained from the Behavioral Risk Factor Surveillance System (BRFSS) dataset (publicly available on the web atwww.cdc.gov/brfss<http://cdc.gov/brfss>).
1. (tie) Alabama and Louisiana (40.0%); 3. Arkansas (38.9%); 4. Mississippi (38.5%); 5. Tennessee (38.2%); 6. West Virginia (37.8%); 7. Indiana (37.0%); 8. Missouri (36.9%); 9. South Carolina (36.8%); 10. Oklahoma (36.7%); 11. Kentucky (36.0%); 12. Iowa (35.9%); 13. Wisconsin (35.4%); 14. North Dakota (35.0%); 15. Texas (34.9%); 16. Ohio (34.8%); 17. North Carolina (34.7%); 18. Georgia (34.6%); 19. Nebraska (34.5%); 20 (tie) Maryland and Michigan (34.4%); 22. Kansas (34.3%); 23. Virginia (34.2%); 24. Illinois (33.6%); 25. Delaware (33.5%); 26. Pennsylvania (33.2%); 27. South Dakota (32.9%); 28. Maine (32.5%); 29. Alaska (32.4%); 30. Utah (32.3%); 31. Idaho (32.1%); 32. Oregon (32.0%); 33. District of Columbia (31.9%); 34. (tie) New Hampshire and Washington (31.3%); 36. Nevada (31.1%); 37. California (31.0%); 38. Florida (30.7%); 39. (tie) New Mexico and Rhode Island (30.2%); 41. Minnesota (30.0%); 42. Wyoming (29.4%); 43. Montana (29.1%); 44. Arizona (28.9%); 45. Connecticut (28.4%); 46. New York (27.6%); 47. Massachusetts (27.5%); 48. New Jersey (27.3%); 49. Hawaii (26.8%); 50. Vermont (26.4%); 51. Colorado (24.6%).

Evaluating Obesity Prevention Efforts

Indicators for Measuring Progress in Obesity Prevention: “Obesity poses one of the greatest public health challenges of the 21st century, creating serious health, economic, and social consequences. Despite acceleration in efforts to characterize, comprehend, and act on this problem, further understanding is needed on the progress and effectiveness of implemented preventive interventions. An IOM committee developed a concise and actionable plan for measuring the nation’s progress in obesity prevention efforts – specifically, the success of policy and environmental strategies recommended in the 2012 IOM report Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation. The committee’s report offers a framework that will provide guidance for systematic and routine planning, implementation, and evaluation of the advancement of obesity prevention efforts. The report’s recommendations focus on efforts to increase the likelihood that actions taken to prevent obesity will be evaluated, that their progress in accelerating the prevention of obesity will be monitored, and that the most promising practices will be widely disseminated.”

CDC ­ Progress on Childhood Obesity

Vital Signs: Obesity Among Low-Income, Preschool-Aged Children — United States, 2008–2011<http://www.cdc.gov/mmwr/preview/mmwrhtml/mm62e0806a1.htm> August 6, 2013 Morbidity and Mortality Weekly Report (MMWR)<http://www.cdc.gov/mmwr/>

"Background: The prevalence of obesity among U.S. preschoolers has doubled in recent decades. Childhood obesity increases the risk for adult obesity and is associated with negative health consequences. Trends in the state-specific prevalence of obesity among low-income U.S. preschool children have not been examined since 2008. State-specific obesity prevalence surveillance helps determine the need for and impact of state and local obesity prevention strategies. Methods: Measured weight and height data from approximately 11.6 million low-income children aged 2–4 years from 40 states, the District of Columbia, and two U.S. territories who participated in the Pediatric Nutrition Surveillance System during 2008–2011 were used to estimate state obesity prevalence. Obesity was defined as having an age- and sex-specific body mass index ≥95th percentile, according to the 2000 CDC growth charts. Logistic regression models adjusted for age, sex, and race/ethnicity were used to examine trends in the state-specific obesity prevalence. Results: During 2008–2011, statistically significant downward trends in obesity prevalence were observed in 18 states and the U.S. Virgin Islands. Florida, Georgia, Missouri, New Jersey, South Dakota, and the U.S. Virgin Islands had the largest absolute decreases in obesity prevalence, each with a decrease of ≥1 percentage point. Twenty states and Puerto Rico experienced no significant change, and obesity prevalence increased significantly in three states. Conclusions and Implications for Public Health Practice: Small but significant declines in obesity among low-income preschoolers were observed in 19 of 43 states/territories examined. Continued prevention efforts are needed to sustain and expand the implementation and evaluation of population-level interventions to prevent childhood obesity."

August 6, 2013

Poor Children Show a Decline in Obesity Rate

By SABRINA TAVERNISE

http://www.nytimes.com/2013/08/07/health/broad-decline-in-obesity-rate-seen-in-poor-young-children.html?ref=health&pagewanted=print

After years of growing concern about obesity among children, federal researchers have found the clearest evidence yet that the epidemic may be turning a corner in young children from low-income families.

The obesity rate among preschool-age children from poor families fell in 19 states and United States territories between 2008 and 2011, federal health officials said Tuesday — the first time a major government report has shown a consistent pattern of decline for low-income children after decades of rising rates.

Children from poor families have had some of the nation’s highest rates of obesity. One in eight preschoolers in the United States is obese. Among low-income children, it is one in seven. The rate is much higher for blacks (one in five) and for Hispanics (one in six).

Several cities have reported modest drops among school-age children, offering hints of a change in course. But gains were concentrated among whites and children from middle- and upper-income families, and were not consistent across the country.

“We’ve seen isolated reports in the past that have had encouraging trends, but this is the first report to show declining rates of obesity in our youngest children,” said Dr. Thomas R. Frieden, director of the Centers for Disease Control and Prevention, which prepared the report. “We are going in the right direction for the first time in a generation.”

The cause of the decline remains a mystery, but researchers offered theories, like an increase in breast-feeding, a drop in calories from sugary drinks, and changes in the food offered in federal nutrition programs for women and children. In interviews, parents suggested that they have become more educated in recent years, and so are more aware of their families’ eating habits and of the health problems that can come with being overweight.

Health officials noted a small decline in the national rate for low-income children for the first time in December, but they did not regard it as important because they lacked a geographic breakdown to show whether the pattern had taken hold in many states.

The new report, based on the country’s largest set of health data for children, used weight and height measurements from 12 million children ages 2 to 4 who participate in federally funded nutrition programs, to provide the most detailed picture of obesity among low-income Americans.

It included data from 40 states, as well as the District of Columbia, Puerto Rico and the United States Virgin Islands. Ten states were not included because of incomplete data. Trained health professionals took the children’s measurements.

“This is the first time we have this many states in the U.S. showing a decline,” said Heidi Blanck, a senior researcher at the C.D.C. “Until now, it has been a patchwork.”

Researchers last analyzed these data in 2009, when only 9 states and territories had obesity declines and 24 had increases. In the report on Tuesday, the proportions were reversed, with only 3 states experiencing increases and 18 states and the Virgin Islands showing declines; 19 states, the District of Columbia and Puerto Rico were flat. The declines were modest: Most states dropped by less than 1 percentage point.

More children were added to the study because of a drop in their income during the economic downturn, leading researchers to investigate whether the decline could be attributed to an influx of new children with lower weights. They concluded that it was not, Dr. Blanck said.

Researchers agreed that the decline was real and held good implications for future health in America. Children who are overweight or obese between age 3 and 5 are five times as likely to be overweight or obese as adults, creating a higher risk of heart disease, stroke, diabetes and cancer.

But there was little consensus on why the decline might be happening.

Children now consume fewer calories from sugary beverages than they did in 1999, Dr. Blanck said. More women are breast-feeding, which can lead to healthier weight gain for young children. Federal researchers have also chronicled a drop in overall calories for children in the past decade, down by 7 percent for boys and 4 percent for girls, but health experts said those declines were too small to make much difference.

Another explanation is that some combination of state, local and federal policies aimed at reducing obesity is starting to have an effect. Michelle Obama has led a push to change young children’s eating and exercise habits and 10,000 child care centers across the country have signed on.

Many scientists doubt that anti-obesity programs actually work, but proponents of the programs say a broad set of policies applied systematically over a period of time can affect behavior.

“We can’t prove what are the changes in environment and policy that led to” the declining rates, Dr. Frieden said. But he added that it was hard to believe that the government policies now in place “aren’t having a big role here.”

Tom Baranowski, a professor of pediatrics at Baylor College of Medicine who has been skeptical about government interventions, said obesity has as much to do with genes as it does with behavior. “It could be that we are hitting some sort of a biological limit,” he said, in which “all those who are genetically predisposed to being obese already are.”

At the Union Baptist Harvey Johnson Head Start, a bright preschool in Baltimore, the focus is on behavior. Children now get health lessons, field trips to a grocery store, healthier meals and an hour of exercise a day on a new jungle gym. Instructors measure children’s height and weight and a nutritionist counsels parents. The income threshold for a family of three is under $20,000.

The share of the school’s approximately 250 children who were obese or overweight fell to 33 percent in 2013, from 35 percent in 2010.

In interviews, parents agreed that encouragement from child care programs like Union Baptist, as well as warnings from doctors, had helped. But just as important, they said, were health worries that have taken hold in low-income communities because of the epidemics of obesity and diabetes.

Shannon Freeland, a 35-year-old pharmacy tech instructor, said both her grandmothers died in their 50s. One, who weighed 300 pounds, had a heart attack, while the other died from diabetes after amputations that began with her toes and ultimately took both legs.

“Grandparents aren’t supposed to pass like that,” said Ms. Freeland, whose first child, Iren, was overweight as a toddler. “That’s when it started to click for me.”

She added, “We were pricking Iren’s finger at age 2, and that was scary for me.”

Ms. Freeland said it was still hard to eat better, partly because it is expensive, but also because with three children, the pull of fast food is strong. She has tried shopping at Whole Foods, but said she cannot afford it. But since going back to college for a degree in public health, she has become more aware of her family’s food habits. Many of her friends are also back in school, avoiding a grim job market.

“People look at Head Start moms and say, ‘Oh they’re just low income and that’s it,’ ” she said. “I think parents have changed. Our income may still be low, but we’re more educated.”        

Food Policy: 11 Trillion Reasons

11 Trillion Reasons

By MARK BITTMAN

Mark Bittman on food and all things related.

Here’s a good line: “[U]nenlightened farm policy — with its massive subsidies for junk food ingredients — has played a pivotal role in shaping our food system over the past century. But that policy can readily be changed.”

With the possible substitution of the word “might” for “can,” this is pretty much an inarguable statement. It comes from “The $11 Trillion Reward: How Simple Dietary Changes Can Save Money and Lives, and How We Get There,” a report produced by the Union of Concerned Scientists (U.C.S.) to be introduced at the farmers’ market[1] at New York’s Mount Sinai Hospital Wednesday.

That’s a big number, $11 trillion, but even if it’s off by 90 percent (it’s difficult to put a value on lives), who’s to scoff at a trillion bucks? In any case, this summary of current research, which contains the argument that even a tiny increase in our consumption of fruits and vegetables would have a powerful impact on health and its costs, agriculture and the economy, is compelling.

About 750,000 United States deaths annually — a third of the total — result from cardiovascular disease, at a medical cost of about $94 billion. The report (and video based on it) maintains that if we upped our average intake of fruits and vegetables by a single serving daily — an apple a day, essentially — more than 30,000 of those lives would be saved (at an overall “value,” according to the report, of $2.7 trillion). Each additional serving of fruit or vegetable would reduce mortality from cardiovascular disease by about 5 percent, to the point where if we all ate the recommended amounts of fruits and vegetables, we’d save more than 100,000 lives and something like $17 billion in health care costs.[2]

This is not new, but the report — written by the U.C.S. agricultural economist Jeffrey K. O’Hara — goes further, and points out that although Department of Agriculture (U.S.D.A.) dietary guidelines encourage all of us to eat sufficient fruits and vegetables to derive these benefits, that same department’s agricultural policy encourages exactly the opposite — that is, damaging — behavior.

Thus we inevitably arrive at the infinitely negotiated Farm Bill, whose subsidies for commodity crops — soy, corn and wheat are our chief concerns — directly promote the production of foods high in hyperprocessed carbohydrates and fats (for simplicity’s sake, junk foods) and the kind of eating that is killing us. These policies come with many obvious direct costs, but also indirect ones. For by subsidizing the production of commodity crops we discourage the farming of fruits and vegetables — the foods that promote health.

A main point of the report is that encouraging farmers to grow fruits and vegetables and sell them locally boosts public health. Therefore, U.C.S. wants to see programs that do just that, plus support research for noncommodity crops, subsidize the development of new outlets for locally grown food and further encourage SNAP (food stamp) users to buy it.

A couple of other interesting points arise here. There’s been a bit of backlash about the new “L” word — local — by some economists, most pushers of industrial agriculture and other skeptics, who scoff at the notion that adequate amounts of food can be grown locally. Putting aside the fact that “increasing regional production” is a more accurate way to describe what progressives in the food movement are advocating (few would argue that all food should be local), it’s worth noting that with little government support the number of farmers’ markets has quadrupled in the last 20 years, and that farm-to-school programs have grown from six in 2001 to more than 10,000 now.

Even if direct subsidies for fruits and vegetables — “specialty crops,” as the U.S.D.A. almost mockingly calls them — were not forthcoming, a decrease in those subsidies for their competition would make these numbers even more impressive.[3]

Ending direct subsidies to what amounts to the enemies of good health makes so much sense that the U.C.S. report has received support from unexpected quarters. Eli Lehrer, president of the R Street Institute, a conservative think tank, told me that “The central point of the report — that government agricultural subsidies contribute to worse health — is an excellent one, one that hasn’t been made in this way.”

Even Lehrer’s critiques of the report are mild: “I can’t say I hate any of the policy recommendations they make — they’d be better than what we’re doing now — but if the subsidies are a problem, then replacing them with different types of subsidies isn’t the solution.”

My fear is that once you do away with subsidies for bad policies, the money is gone, and it will be difficult to get it back for the kind of programs U.C.S. advocates.

Still: I’ll stand on common ground with anyone who wants to abandon subsidizing the growing of corn, Big Food’s production of junk and, ultimately, the undermining of public health. What happens afterward can hardly be worse.

That’s the kind of thinking that Joshua Sewell, a senior policy analyst at the fiscally conservative Taxpayers for Common Sense, expressed as well: “There’s a notion that we have to have spending on agriculture, but where’s the money going and what are we getting out of it? The first step is to shift the paradigm and stop the harmful system we have now. The second step is to figure out the proper role of government, how to spend our money in a cost-effective manner: land grant universities should be doing research in the public interest, not corporate philanthropy.”

It’s not “cost-effective” — or, to put it more simply, smart — to subsidize the producers of food that makes us ill. They don’t need it — they’re already profitable, in part thanks to decades of subsidies — and there is no logic in helping corporations who are in the business of poisoning us to be more profitable. If government money is to go to agriculture, it should go to those farmers who are eager to grow the foods that will sustain us. What that’s worth is inestimable.

---

1. This is National Farmers Market Week, by the way. I’ve already celebrated.

2. Note that this way of looking at things skips right by the obesity argument — which is fraught with controversy — and simply looks at the well-established notion that when you replace junk food with real fruits and vegetables you improve health.

3. Imagine how much more food would be grown locally and purchased at farmers markets if more cities had permanent structures like the Reading Terminal Market in Philadelphia or Eastern Market in Detroit, central markets where farmers were guaranteed not only space and shelter but a weekly or even daily crowd.

F.D.A. Sets a Standard on Labeling ŒGluten Free¹

August 2, 2013

F.D.A. Sets a Standard on Labeling ‘Gluten Free’

By SABRINA TAVERNISE

WASHINGTON — The federal government on Friday set a standard for gluten-free claims on food labels, a step that health officials said would help the three million Americans with celiac disease and bring uniformity to the $4 billion market for gluten-free products.

Gluten is a composite of starch and proteins found in certain grassy grains like wheat, barley and rye. When eaten by people with celiac disease, gluten can trigger the production of antibodies that damage the lining of the small intestine.

To protect people with the disease, Congress passed a law in 2004 calling on the Food and Drug Administration to set standards for how much trace gluten could be in foods whose labels said they were gluten free. A standard became even more urgent, observers said, when broader consumer demand for gluten-free foods drove the rapid expansion of the market.

The F.D.A.’s publication on Friday of the final rule is the culmination of that process.

The agency set a gluten limit of 20 parts per million in products labeled gluten free, said Michael R. Taylor, deputy commissioner for foods and veterinary medicine at the F.D.A. The limit had long been discussed and did not come as a surprise to industry or patient advocate groups. It was similar to the level adopted in recent years by the European Union and Canada, Mr. Taylor said.

According to Packaged Facts, a consumer market research company, sales of gluten-free products stood at $4.2 billion in 2012, nearly triple what they were in 2008.

In a poll of consumers in August 2012, Packaged Facts found that the top two reasons people gave for buying gluten-free food was that they believed it was healthier and that it would help them manage their weight. Experts say there is no evidence that such foods help with weight loss.

Dr. Alessio Fasano, the director of the Center for Celiac Research at Massachusetts General Hospital in Boston, helped develop the science to determine how much gluten was too much for celiac disease patients. He said that when he first started researching the topic in the early 1990s, the definition “was all over the map.”

He called the rule issued on Friday “a big deal” because it gives people with celiac disease, an autoimmune disorder, confidence that the food they buy will not make them sick. “A gluten-free diet for people with celiac disease is like insulin for diabetics,” Dr. Fasano said.

The F.D.A. first proposed the 20 parts per million standard in 2007, Mr. Taylor said, and companies have used that limit as a guide for their products even before the new rule was published.

“We frankly think that the great majority of products have been driven to that level,” he said.

The agency has tools to keep companies in compliance. It can seize products whose gluten level is above the limit, or require companies to recall products. But Mr. Taylor said he doubted much of that would be necessary. Industry favors the rule, he said, as it sets a level playing field and gives consumers peace of mind.

“We don’t think compliance will be a problem,” Mr. Taylor said. “Industry wants this rule. They have huge incentive to comply with it. They want people to be confident.”

Boulder Brands, a food company based in Boulder, Colo., that makes the Glutino and Udi’s brands, applauded the new standard, saying in a statement that it would create “a uniform definition for what gluten free means across all products.”